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A Different Approach for Different Results

Orthopedics
“I’m an elementary school gym teacher. I could still do my job — I just wasn’t able to do it the way I wanted to. I’m a younger guy and it’s nice because kids want to play with you, and you want to show them things yourself … and unfortunately, I had to take more of a backseat.”

Austin Polcaro was a high school athlete when a sports injury forever changed his life. With aspirations of being a physical education teacher, his future goals were called into question after a soccer match incident.

“I was 17 at the time. I just jumped in the air for a header, and I came down to change directions and my knee popped out of place,” he recounted.

Austin ended up tearing his anterior cruciate ligament (ACL) and meniscus. It’s a story that’s all too common in young athletes. He underwent a reconstructive procedure that worked for a while, but another sports injury set him back in recovery.

“I was boxing, doing some light sparring and I pivoted. That’s when it gave out again,” Austin sighed.

He underwent six orthopedic surgeries over the course of 10 years, including two failed ACL reconstruction surgeries. After struggling with pain for a decade, Austin began to lose hope that his pain would go away.

“I’d have good years,” noted Austin. But then he’d end up with another injury and find himself back in surgery.

“I got to the point where I didn’t know if I would ever even have surgery again. You try something so many times that keeps failing … why keep trying it,” he lamented.

“I’m an elementary school gym teacher. I could still do my job — I just wasn’t able to do it the way I wanted to. I’m a younger guy and it’s nice because kids want to play with you, and you want to show them things yourself … and unfortunately, I had to take more of a backseat,” he acknowledged.

Austin finally made the decision to work with Orthopaedic Surgeon Kyle Martin, MD, at CentraCare M Physicians Orthopedics.

Dr. Martin was tasked with finding a different approach to Austin’s knee issues. “We spent a significant amount of time talking about different things we have in our tool belt to approach this problem and address each of his concerns — the pain and instability were part of it. He felt like he couldn’t trust his knee,” echoed Dr. Martin.

The surgeons at CentraCare M Physicians Orthopedics spend a great deal of time managing a patient’s expectations. “I would never want to promise someone we’re going to give them a normal knee or a knee that never hurts. Our goals in these situations are to have less pain and more function than he currently has,” clarified Dr. Martin.

Austin ended up undergoing two surgeries. The first one revealed what his knee looked like on the inside and how bad the damage to his cartilage and meniscus were. During that same surgery, he also underwent another bone grafting procedure at the site of his previous ACL reconstruction. That surgery confirmed that a meniscus transplantation was needed for his second surgery.

Austin became one of the first patients in St. Cloud to undergo a meniscus transplant. It’s a process that involves finding a cadaver donor that is size matched to the patient from a bone bank.

“We had to do something different if we wanted to expect different results,” affirmed Dr. Martin.

At the same time as the transplant, Dr. Martin also performed a repeat revision ACL reconstruction using an ACL graft from Austin’s other knee. The final piece was also to perform a lateral extra-articular tenodesis — an extra procedure that has recently been shown to lower failure rates for ACL reconstruction.

Austin is more than 18-months out from his most recent surgery and is doing well. He says he’s glad he took Dr. Martin’s advice. “I was thinking about just saying no to surgery and kind of living with the pain … the alternative to surgery was to spend the next 40 or 50 years in a brace every day.”

CentraCare M Physicians Orthopedics is a partnership between CentraCare and University of Minnesota Orthopedics (M Physicians).

“The collaboration gives us the ability to perform procedures like this that require a higher level of training and experience or that haven’t been performed in Central Minnesota before. The goal is to provide the care people need locally, without requiring them to travel down to the Twin Cities for these procedures,” asserted Dr. Martin.

Austin has been able to return to activities he enjoyed before his knee injuries. “I coach boxing in town. I haven’t boxed since I was 17, and I just took a fight last year. It’s the first time I’ve boxed in 10 or 11 years,” he marveled.

“That’s the goal. I try not to restrict people’s activity levels after surgery because that’s the whole point of doing the surgery — to get them back to the activities they want to do and need to do,” assured Dr. Martin.